PMID- 16442912
OWN - NLM
STAT- MEDLINE
DCOM- 20060210
LR  - 20220321
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Print)
IS  - 0002-8703 (Linking)
VI  - 151
IP  - 2
DP  - 2006 Feb
TI  - Higher New York Heart Association classes and increased mortality and 
      hospitalization in patients with heart failure and preserved left ventricular 
      function.
PG  - 444-50
AB  - BACKGROUND: The association between higher New York Heart Association (NYHA) 
      class and outcomes in patients with heart failure and preserved systolic function 
      is not well known. METHODS: We performed a retrospective follow-up study of 988 
      patients with heart failure with ejection fraction > 45% who participated in the 
      DIG trial. Using Cox proportional hazard models, we estimated risks and all-cause 
      mortality, heart failure mortality, all-cause hospitalization, and 
      hospitalization due to worsening heart failure during a median follow-up of 38.5 
      months. RESULTS: Patients had a median age of 68 years; 41.2% were women and 
      13.9%, nonwhites. Overall, 23.4% of patients died, and 19.9% were hospitalized 
      because of worsening heart failure. Proportion of patients with NYHA classes I, 
      II, III, and IV were 19.9%, 58.0%, 20.9%, and 1.2%, respectively, and 14.7%, 
      21.1%, 35.9%, and 58.3%, respectively, died of all causes (P < .001 for trend). 
      Respective rates for heart failure-related hospitalizations were 14.2%, 17.1%, 
      32.5%, and 33.3% (P < .001 for trend). Compared with NYHA class I patients, 
      adjusted hazard ratios (HRs) for all-cause mortality for class II, III, and IV 
      patients were 1.54 (95% CI 1.02-2.32, P = .042), 2.56 (95% CI 1.64-24.01, P < 
      .001), and 8.46 (95% CI 3.57-20.03, P < .001), respectively. Respective adjusted 
      HRs (95% CI) for hospitalization due to heart failure for class II, III, and IV 
      patients were 1.16 (0.76-1.77) (P = .502), 2.27 (1.45-3.56) (P < .001), and 3.71 
      (1.25-11.02) (P = 018). New York Heart Association classes II through IV were 
      also associated with higher risk of all-cause hospitalization. CONCLUSION: Higher 
      NYHA classes were associated with poorer outcomes in patients with heart failure 
      and preserved systolic function.
FAU - Ahmed, Ali
AU  - Ahmed A
AD  - Division of Gerontology and Geriatric Medicine, Department of Medicine, 
      University of Alabama, Birmingham, AL, USA. aahmed@uab.edu
FAU - Aronow, Wilbert S
AU  - Aronow WS
FAU - Fleg, Jerome L
AU  - Fleg JL
LA  - eng
GR  - K23 AG019211/AG/NIA NIH HHS/United States
GR  - K23 AG019211-02/AG/NIA NIH HHS/United States
GR  - K23 AG019211-03/AG/NIA NIH HHS/United States
GR  - 1-K23-AG19211-01/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Cardiotonic Agents)
RN  - 73K4184T59 (Digoxin)
SB  - IM
MH  - Aged
MH  - Cardiotonic Agents/therapeutic use
MH  - Cause of Death
MH  - Diabetes Complications/mortality
MH  - Digoxin/therapeutic use
MH  - Female
MH  - Heart Failure/*classification/drug therapy/*mortality/physiopathology
MH  - Hospitalization
MH  - Humans
MH  - Kidney Diseases/complications
MH  - Male
MH  - Proportional Hazards Models
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - *Severity of Illness Index
MH  - Statistics, Nonparametric
MH  - *Stroke Volume
PMC - PMC2771182
MID - NIHMS78002
EDAT- 2006/01/31 09:00
MHDA- 2006/02/14 09:00
PMCR- 2009/11/01
CRDT- 2006/01/31 09:00
PHST- 2004/11/01 00:00 [received]
PHST- 2005/03/26 00:00 [accepted]
PHST- 2006/01/31 09:00 [pubmed]
PHST- 2006/02/14 09:00 [medline]
PHST- 2006/01/31 09:00 [entrez]
PHST- 2009/11/01 00:00 [pmc-release]
AID - S0002-8703(05)00521-1 [pii]
AID - 10.1016/j.ahj.2005.03.066 [doi]
PST - ppublish
SO  - Am Heart J. 2006 Feb;151(2):444-50. doi: 10.1016/j.ahj.2005.03.066.